Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2081P2900X | Pain Medicine | ME0075301 | FL |
NPI | 1326041542 |
---|---|
Provider Name | Dr. Allen C Tafel |
First Address | Ft Myers, FL 33901-4900 |
Second Address | Ft Myers, FL 33901-4900 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/05/2005 |
Last Update Date | 14/08/2015 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
F62033 | (02) |